Indications for intracranial pressure (ICP) monitoring
| Condition | Comments |
|---|---|
| Subarachnoid haemorrhage | With associated hydrocephalus–ventriculostomy allows therapeutic drainage and ICP monitoring |
| ? patients in coma | |
| ? as a guide to hypertensive hypervolaemic treatment for delayed ischaemia | |
| Spontaneous intracerebral haemorrhage | There is no good clinical evidence of benefit from monitoring patients in this group |
| Reye’s syndrome | Active treatment of raised ICP decreases mortality |
| Blood ammonia >300 mg/100 ml and deteriorating conscious level usually considered indications for monitoring | |
| Brain tumours | Not indicated routinely, but may be of value in selected patients deemed at high risk of swelling or obstructive hydrocephalus—for example, following posterior fossa surgery |
| Normal pressure hydrocephalus | An increase in spontaneous nocturnal “B” waves has been reported to be predictive of a good response to CSF diversion |
| Decompensated hydrocephalus | Can be a valuable diagnostic tool in complex cases |
| “Benign” intracranial hypertension | Monitoring often undertaken via a lumbar subarachnoid catheter as both a diagnostic test and to monitor response to treatment |
| Other potential indications | Hypoxic brain swelling after drowning, meningitis, encephalitis, venous sinus thrombosis, and hepatic encephalopathy |